Diet, nutrition and the context of risk, part 2 – Food Poisoning

Other than the morbidity and mortality linked to eating too much food, “all natural” organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emsulfiers, artificial sweeteners and pesticides combined. In fact, the numbers are staggering (see table 1) and yet, for some reason, food poisoning does not seem to resonate compared to more innocuous or esoteric threats. For example, when I lecture on the topic, the possibility that GMO crops might cause widespread illness someday (it hasn’t yet) generates much more passion than the widespread illness that is caused every year by contaminated food. After reading quite a bit about it, I believe part of the problem is that many people don’t recognize food poisoning when they have it, since the CDC estimates one of every six Americans contracts it every year. In other words, people know they’re sick when symptoms such as an upset stomach, abdominal cramps, nausea, diarrhea and vomiting are present. The problem is that they call it the stomach flu or the 24 hour flu — two ailments that technically don’t exist (see insert) -- when in fact they probably have food poisoning.

Insert
The Stomach Flu and the 24 Hour Flu are not the Flu. The Influenza virus family causes the Flu, which is a contagious disease that affects the upper respiratory system. What is referred to as the stomach flu or the 24 hour flu is not the flu, nor is it caused by the influenza virus. It is gastroenteritis (irritation of the GI tract that causes abdominal pain, nausea, vomiting and diarrhea). See tables 2 & 3 for the causes.

Stats & Facts
More than 200 known diseases are transmitted through food. [1]
Norovirus is the leading cause of illness and outbreaks from contaminated food in the United States. [2]
Salmonella is the second leading cause of food poisoning. There are almost 7000 serotyped Salmonella isolates [3]
Long term effects from food poisoning include kidney disease from E.Coli and arthritis is possible from Salmonella among others. [4]
Campylobacter infection causes over a third of Guillain-Barré syndrome cases [4]
Most people don’t realize they have food poisoning because most do not get sick enough to have the laboratory tests required to confirm an organism caused their illness. For example, for every 1 case of Salmonella illness that is confirmed in the laboratory, there are ~ 30 cases of Salmonella illnesses that were not confirmed. [5]

Misconceptions
An Arizona Department of Health Services epidemiologist shed light on why food poisoning is so tricky to diagnose. [6]
- Most of the time, the last thing you ate wasn’t what made you sick.
- Many foodborne diseases don’t produce the toxins until after they are in your intestines and once the process begins, it can take days to weeks for levels to increase enough to cause problems.
- The same pathogen can affect different people differently.
- Sometimes only one person gets sick after eating a shared meal that was contaminated.
- A persons current immune status & stress level plays a role in who can stop a bug and who cannot.
- Good fortune can dictate who misses a pocket of high infestation when sharing a common source such as an appetizer.

References
1. http://wwwnc.cdc.gov/eid/article/5/5/99-0502_article. Accessed 3-11-16
2. http://www.cdc.gov/norovirus/about/transmission.html. Accessed 3-10-16
3. http://www.cdc.gov/mmwr/pdf/wk/mm6215.pdf. Accessed 3-12-16
4. http://www.foodsafety.gov/poisoning/effects Accessed 3-13-16
5. http://www.cdc.gov/features/vitalsigns/foodsafety. Accessed 3-12-16
6. Kellis, M. Dispelling 5 myths about food poisoning. The Desert News. 4-14-2015
7. http://www.cdc.gov/foodborneburden/2011-foodborne-estimates.html. Accessed 2-29-2016

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